Brief scale measuring patient preparedness for hospital discharge to home: Psychometric properties

Abstract

BACKGROUND: Adverse events occur when patients transition from the hospital to outpatient care. For quality improvement and research purposes, clinicians need appropriate, reliable, and valid survey instruments to measure and improve the discharge processes. OBJECTIVE: The object was to describe psychometric properties of the Brief PREPARED (B-PREPARED) instrument to measure preparedness for hospital discharge from the patient's perspective. METHODS: The study was a prospective cohort of 460 patient or proxy telephone interviews following hospital discharge home. We administered the Satisfaction with Information about Medicines Scale and the PREPARED instrument 1 week after discharge. PREPARED measured patients' perceptions of quality and outcome of the discharge-planning processes. Four weeks after discharge, interviewers elicited emergency department visits. The main outcome was the B-PREPARED scale value: the sum of scores from 11 items. Internal consistency, construct, and predictive validity were assessed. RESULTS: The mean B-PREPARED scale value was 17.3 AE 4.2 (SD) with a range of 3 to 22. High scores reflected high preparedness. Principal component analysis identified 3 domains: self-care information, equipment/services, and confidence. The B-PREPARED had acceptable internal consistency (Cronbach's alpha 0.76) and construct validity. The B-PREPARED correlated with medication information satisfaction (P < 0.001). Higher median B-PREPARED scores appropriately discriminated patients with no worry about managing at home from worriers (P < 0.001) and predicted patients without emergency department visits after discharge from those who had visits (P 5 0.011). CONCLUSIONS: The B-PREPARED scale measured patients' perceptions of their preparedness for hospital discharge home with acceptable internal consistency and construct and predictive validity. Brevity may potentiate use by patients and proxies. Clinicians and researchers may use B-PREPARED to evaluate discharge interventions.

Improving Care Transitions: The Patient Perspective

“…During the sometimes chaotic discharge period, many patients are sent home without adequate instruction on medication management, follow-up appointments, and other necessary information to be successful post-discharge (Cua & Kripalani, 2008; Greenwald, Denham, & Jack, 2007). Consequently, patients often feel ill-prepared to provide appropriate self-care during the transition to home (Graumlich, Novotny, & Aldag, 2008). Incomplete or delayed communication between inpatient and outpatient providers further complicates post-discharge care (S.…”

The readiness for hospital discharge of patients after acute myocardial infarction: a new self-reported questionnaire

“…The reliability of the Chinese and French versions were also high, with a-Cronbach coefficients of 0.89 and 0.80, respectively [14,15]. The internal consistency of another instrument to measure preparedness for hospital discharge: the Brief PREPARED (B-PREPARED) reported by Graumlich et al [16], was also acceptable (a-Cronbach of 0.76).…”

Determinants of health after hospital discharge: rationale and design of the Vanderbilt Inpatient Cohort Study (VICS)

“…The quality of discharge planning is assessed during the post-discharge telephone call using the B-PREPARED instrument, [39] which measures participants’ perceptions of the discharge planning process and their level of preparation for performing self-care. Additionally, the quality of the care transition from hospital to home is measured using the Care Transitions Measure-3 (CTM-3) [40].…”